Small Bowel Disease Flashcards
What is a gallstone ileus?
Large gallstone migrates via fistulas into the small intestine and become lodged
What is the most common fistula associated with the gall bladder and small intestine?
Cholecystoduodenal
List some symptoms of small bowel obstruction
Colicky abdo pain (sudden, cramp like)
Absolute constipation (no flatus/burping)
Abdominal distention
Faeculent vomiting
Is surgery common for small bowel obstruction?
Not really as most settle with management
Outline general treatment of small bowel obstruction
Analgesia
Fluids + potassium (lose K in vomit)
NG tube draining
Anti-embolism measures
When would surgery be done early for small bowel obstruction?
Strangulation
Perforation
Ischaemia
PREVENT DEAD GUTS
In mesenteric/small bowel ischaemia, the colon is usually unaffected. True/False?
True
Marginal artery of Drummond provides collateral supply
What is the typical symptom of mesenteric ischaemia?
Cramping pain
Essentially “angina of the gut”
What is the first-line treatment for mesenteric ischaemia?
Surgery! No faffing around
PREVENT DEAD GUTS
Upon surgery, if part of the intestine is necrotised, what is done?
Resected (up to a limit)
Where does Meckel’s diverticulum occur?
60cm from ileocaecal valve
When does Meckel’s diverticulum present?
Usually before 2yrs of age
What is the most common cause of small bowel ischaemia?
Mesenteric atherosclerosis, thromboembolism
Increasing the time of ischaemia increases the depth of small bowel infarction. True/False?
True
List some complications of small bowel ischaemia
Scarring, fibrosis -> stricture
Gangrene
Perforation
